A Rare cause of Bloody Defecation: A Case Report

Abstract

Tuberculosis, which is mainly caused by the mammalian tubercle bacilli, Mycobacterium tuberculosis complex, is life-threatening disease transmitted from human-tohuman via the airborne route. Gastrointestinal tract (GIT) tuberculosis is usually caused by swallowing infected sputum or spread of bacilli smears to the GIT. A 36-year-old male patient presented to our outpatient clinic with a one-year history of weight loss, abdominal pain, nausea, and bloody stools for the past three months. Colonoscopy revealed giant and mucopurulent exudates in the cecum, ileocecal valve, and ileum. On histopathological examination, both ileum and ascending colon biopsies showed multiple granuloma formations with caseous necrosis and multinuclear giant cells. The Ehrlich-Ziehl-Neelsen histochemical staining revealed multiple foci of acid-fast bacilli compatible with Mycobacterium tuberculosis. Chest X-ray showed bilateral infiltration of the upper zones. Acid-resistant bacilli were positive in the sputum smear test. The patient was diagnosed with GIT and pulmonary tuberculosis and appropriate treatment was initiated. This rare case highlights the importance of accurate diagnosis of tuberculosis and delayed diagnosis can cause the bacteria to infect other organs through blood, lymphatic system, or direct spread.